| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $89.34 | $1,612.78 | $12,179.28 | |
Aetna
| Professional | $89.34 | $99.26 | $2,287.84 | |
BCBS
| Facility | $52.59 | $52.59 | $52.59 | |
Cigna
| Facility | $19.98 | $89.34 | $89.34 | |
Cigna
| Professional | $89.34 | $89.34 | $89.34 | |
United
| Professional | $89.34 | $91.13 | $117.93 |